RESUMO
Tactfully breaking news is an essential communication skill in the health professions. By the end of medical undergraduate training, the majority of students should be competent at breaking bad news in standardized patient examinations. Recent studies, however, suggest that this skill is not easily learned and there are notable differences in the strategies employed by males and females, even among practising professionals. These findings point to the possibility of gendered performance within medical school and raise questions about the efficacy of communication skills training. This chapter evaluates gendered achievement patterns and overall competence at breaking bad news on OSCE stations in years 2 and 5 for three cohorts of students at the School of Medicine, Faculty of Medical Sciences, University of the West Indies (UWI), St Augustine. Gender differentials were calculated for: (1) station scores, (2) item categories, and (3) item scores and evaluated on (1) statistical and practical significance, (2) variability, and (3) gendered impact. More than 25 percent of the students scored below the minimum level of competence for three of four years. However, there were few statistically or practically significant gender differentials on individual skills and process tasks. Nevertheless, by year 5, some females had a significant lead over males in the employment of socio-emotional/supportive strategies. It may be that the formal communication skills training (CST) programme, in the early years, did not lead to final-year mastery for some males. There is also the possibility that males and females prefer different strategies. There may be a need for contextualized training that allows both males and females to adopt a more patient-centred approach.